EXHIBIT A

COMMISSIONER'S REPORT OF EXAMINATION

STATE OF ARKANSAS

DEPARTMENT OF INSURANCE

APPROVAL OF LICENSE AS A VARIABLE ANNUITY AGENT

Name of Applicant

When validated by the Department of Insurance, this will be your notice of approval of your qualification for a Variable Annuity agent's license.

Address

Enter Name and Address of broker or dealer and of the company to which approval of Application for Variable Annuity agent's license should be directed.

Broker-Dealer

LICENSE APPROVED

Date

Address

Commissioner of Insurance

Company

TEST SCORE:-EXAMINATION

Securities

Part I

Variable Annuities

Part II

If Test Waived, Indicate Variable Contract Regulation Section Conferring Exemption

If a "securities examination" score (other than Part I of the NAIC examination) is offered in satisfaction of the requirement of Paragraph 9.3 of the Regulations, identify the test and score below.

NAME OF TEST TEST SCORE